OVER THE NEXT week some 12,000 people across the country aged 85 and over will receive their first dose of a Covid-19 vaccination, as the immunisation programme moves into its third phase.

The health service has said it aims to move into the next cohort – those aged 80-84 – in around three weeks’ time.

Recent advice from the country’s immunisation advisory committee (NIAC) forced the HSE to quickly shift gear to facilitate the use of two mRNA vaccines produced by Pfizer/BioNTech and Moderna, rather than the less complicated AstraZeneca vaccine. 

For some, this means the venue for their vaccination has also changed though the majority of patients will be able to receive their jab in their own GP’s surgery.

Who is getting the vaccine this week?

From today, people aged over 85 will receive the vaccine. Some 12,000 doses will be delivered to GP surgeries and to vaccination centres across the country. 

We're heading into a more positive phase in dealing with #COVID19. We all wish we had more supplies to vaccinate quicker. But soon we'll have our most vulnerable living in care homes and in the community protected. And supplies improve from this week too. #Hope @HSELive

— Paul Reid (@paulreiddublin) February 15, 2021

How will I know when my appointment is?

Speaking at a briefing last week Dr Nuala O’Connor, Covid clinical lead for the Irish College of General Practitioners (ICGP), said GPs will be contacting patients to let them know when their appointments are and where they should go.

“Almost everybody over 70 in Ireland is entitled to a GP GMS (General Medical Services) card, either a full one or a Doctor’s Visit Card. So that’s how we know the exact number,” she said.

“The PCRS (Primary Care Reimbursement Service) knows exactly how many over 85 patients are registered with every single GP in the country. Then we were asked to do an audit and validation exercise.

You’d have patients that are officially registered but for instance I have a lady and her mum who lives in Co Meath has been cocooning with them in Cork and she was saying ‘oh we’ll have to bring Mum up to county Meath for two doses’ and I said ‘no, we will get that’.

“We’ve a few people like that, we added them to our list and we have a few people who just chose not to get a medical card. We’ve another lady who’s from Europe who has come to stay with her family here. She’s a European citizen. There’s a few people like that.”

Dr O’Connor said the HSE sent an email to her office asking her to confirm the number on the PCRS with her own database and she replied with figures to include any additional patients.

Each GP practice will have a ‘back-up’ list for the day, with patients to call in if there are additional doses. This will ensure that there is no waste if they manage to get more than six doses out of each vial or if they have cancellations, O’Connor said.

“What we’ve done is we’ve ordered 16 vials, which will each have six doses – we can absolutely take six doses,” she explained.

“But the good news is that with the dead space syringes we will hopefully get an extra 16 doses – one dose per vial – so we will have our contingency list of the next group and we’ll have them ready.”

Which vaccine will people get?

The National Immunisation Advisory Committee (NIAC) has advised that people aged 70 and over should only receive mRNA vaccines – such as the Pfizer/BioNTech or Moderna ones – where possible.

This followed guidance from the European Medicines Agency (EMA) which stated that there was not enough data to provide a figure for how well the vaccine will work in those aged over 55.

“However, protection is expected, given that an immune response is seen in this age group and based on experience with other vaccines; as there is reliable information on safety in this population, EMA’s scientific experts considered that the vaccine can be used in older adults,” the EMA said.

Last week the World Health Organization recommended the use of the AstraZeneca vaccine in all adults. However, Ireland’s advisory committee has not issued any new advice.

This means that this week all 12,000 doses administered to people aged over 85 will be the Pfizer/BioNTech vaccine. 

What will the AstraZeneca vaccine be used for?

The first delivery of the AstraZeneca vaccine arrived last week and the first doses were administered from Monday to healthcare workers.

Ireland will continue to receive doses of this vaccine and over the course of this week 22,000 doses of it will be administered to frontline healthcare workers. 

Where will the vaccines be administered?

The majority of people will get their vaccine at their own GP’s surgery. This week 84 practices – many with several GPs working in them – will be involved in the initial roll-out.

Smaller practices or those with fewer than 200 patients in this age group will ‘buddy up’ with other local GPs, with some grouping together at a larger practice. 

The Moderna vaccine is packed in 100 doses and the Pfizer one can only be packed down to 36 doses, so these measures are to ensure no doses are wasted in practices that have fewer over 85s. 

A small number of mass vaccination centres in venues such as The Helix in DCU and Cork Institute of Technology will also be used. The Helix will be used by 121 GPs this week to vaccinate 1,600 of their patients.

Next week marks a nice milestone as the vaccination of the aged 85+ living in the community starts. Most vaccinations will happen in GP practices. In @DCU 121 GPs will also come together and vaccinate 1600 of their patients in one of our vaccination centres. @HSELive @ICGPnews pic.twitter.com/ZibB3aVXUk

— Paul Reid (@paulreiddublin) February 12, 2021

What about people who need to get the vaccine in their homes?

The HSE has said arrangements will be made, where possible, to transport people to their appointments if required. 

Speaking to TheJournal.ie, Dr Denis McCauley, Chairman of the GP Committee of the IMO, said no specific arrangements have yet been made for people who are housebound.

“There is significant planning going on in the background to see if there is a way to get this very delicate vaccine to people, or whether we can get an alternative one – do we want to wait until we have access to an mRNA vaccine that is more mobile?

“The planning on this is very active, we know this is a vulnerable group.”

How long will it take to get through this entire cohort?

There are more than 480,000 people aged over 70 in Ireland, with more than 72,000 aged over 85.

HSE CEO Paul Reid has said he expects everyone in this over 70s cohort to have received their first dose by mid-April and their second dose by the middle of May.

The HSE has said during this third phase it will also go back to older people in residential care who did not receive a vaccine during the initial phases of the programme due to outbreaks or their own diagnosis with Covid-19.

Although the plans had to change significantly in a short space of time for this next phase, Dr Denis McCauley said GPs are feeling confident about their own preparedness. 

“Once it gets going we’ll be fine. People have been getting their emails and putting their orders in,” he said.

“This is a new system, hopefully there won’t be any glitches and once we’ve completed one cycle of delivery everybody will be much more comfortable.”